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Q1. Approximately what percentage of erythropoietin is produced by the kidneys?
A. 50%
B. 70%
C. 90%
D. 100%
Answer: C. 90%
Rationale: The kidneys are the primary source of erythropoietin (EPO), producing
about 90%, while the liver and other tissues contribute about 10%.
Q2. What percentage of erythropoietin is produced by the liver and other organs?
A. 2%
B. 5%
C. 10%
D. 25%
Answer: C. 10%
Rationale: The liver and extra-renal tissues contribute only ~10% of total EPO
production.
Q3. How does kidney dysfunction primarily affect red blood cell development?
A. It accelerates red blood cell turnover.
,B. It increases platelet production.
C. It reduces erythropoietin production.
D. It enhances bone marrow activity.
Answer: C. It reduces erythropoietin production.
Rationale: CKD results in reduced EPO production, impairing bone marrow
stimulation and RBC development.
Q4. Deficiencies of which nutrients may contribute to anemia in chronic kidney
disease?
A. Vitamin A, Vitamin D, Zinc
B. Vitamin B12, Iron, Folate
C. Calcium, Magnesium, Phosphate
D. Vitamin K, Potassium, Sodium
Answer: B. Vitamin B12, Iron, Folate
Rationale: These deficiencies commonly contribute to anemia in CKD, along with
reduced EPO.
Q5. What hemoglobin level defines chronic anemia in adult males?
A. <14.5 g/dL
B. <13.0 g/dL
C. <12.0 g/dL
D. <11.0 g/dL
Answer: B. <13.0 g/dL
Rationale: In adult males, anemia is defined as Hb <13 g/dL.
Q6. What hemoglobin level defines chronic anemia in adult females?
A. <14.0 g/dL
B. <13.0 g/dL
,C. <12.0 g/dL
D. <11.5 g/dL
Answer: C. <12.0 g/dL
Rationale: In adult females, anemia is defined as Hb <12 g/dL.
Q7. What is the most profound hematologic alteration that accompanies CKD?
A. Leukocytosis
B. Thrombocytopenia
C. Chronic anemia
D. Polycythemia
Answer: C. Chronic anemia
Rationale: Due to decreased EPO production and nutrient deficiencies, chronic
anemia is the hallmark hematologic abnormality in CKD.
Q8. In advanced CKD among African Americans, GFR decline is associated with:
A. Increased leukocyte count
B. Decline in hematocrit
C. Hypercalcemia
D. Thrombocytosis
Answer: B. Decline in hematocrit
Rationale: Research demonstrates a strong association between declining GFR
and falling hematocrit levels.
Q9. According to NKF guidelines, individuals with a GFR <60 mL/min/1.73 m²
should be:
A. Started on dialysis immediately
B. Evaluated for anemia
, C. Placed on iron therapy without testing
D. Referred for bone marrow biopsy
Answer: B. Evaluated for anemia
Rationale: National Kidney Foundation (NKF) guidelines recommend anemia
screening in CKD patients with GFR <60.
Q10. Which measures are included in the assessment of anemia in CKD?
A. Hemoglobin, hematocrit, iron stores
B. Sodium, potassium, chloride
C. Glucose, A1C, insulin levels
D. White blood cell count only
Answer: A. Hemoglobin, hematocrit, iron stores
Rationale: These are the key labs used to diagnose and monitor anemia in CKD.
Q11. Which of the following factors may contribute to anemia in CKD?
A. Chronic blood loss, hemolysis, bone marrow suppression
B. Hyperglycemia, dehydration, electrolyte imbalance
C. Vitamin D deficiency, calcium loss, bone resorption
D. Increased EPO production, high oxygen demand
Answer: A. Chronic blood loss, hemolysis, bone marrow suppression
Rationale: All three, along with decreased RBC production, contribute to CKD
anemia.
Q12. Why is erythropoietin production insufficient in kidney failure?
A. Bone marrow resistance
B. EPO overproduction
C. Kidney damage reduces EPO synthesis
D. Increased degradation of EPO